Abstract：
BACKGROUND: Secondary meningioma after cranial irradiation, so-called radiation-induced meningioma, is one of the important late effects after cranial radiation therapy. In this report, we analyzed our case series of secondary meningioma after cranial irradiation and conducted a critical review of literature to reveal the characteristics of secondary meningioma.
METHODS: We performed a comprehensive literature review by using Pubmed, MEDLINE and Google scholar databases and investigated pathologically confirmed individual cases. In our institute, we found pathologically diagnosed seven cases with secondary meningioma between 2000 and 2018. Totally, 364 cases were analyzed based on gender, WHO grade, radiation dose, chemotherapy. The latency years from irradiation to development of secondary meningioma were analyzed with Kaplan-Meier analysis. Spearman\'s correlation test was used to determine the relationship between age at irradiation and the latency years.
RESULTS: The mean age at secondary meningioma development was 35.6 ± 15.7 years and the mean latency periods were 22.6 ± 12.1 years. The latency periods from irradiation to the development of secondary meningioma are significantly shorter in higher WHO grade group (P = 0.0026, generalized Wilcoxon test), higher radiation dose group (P < 0.0001) and concomitant systemic chemotherapy group (P = 0.0003). Age at irradiation was negatively associated with the latency periods (r = -0.23231, P < 0.0001, Spearman\'s correlation test).
CONCLUSIONS: Cranial irradiation at older ages, at higher doses and concomitant chemotherapy was associated with a shorter latency period to develop secondary meningiomas. However, even low-dose irradiation can cause secondary meningiomas after a long latency period. Long-term follow-up is necessary to minimize the morbidity and mortality caused by secondary meningioma after cranial irradiation.
METHODS: We performed a comprehensive literature review by using Pubmed, MEDLINE and Google scholar databases and investigated pathologically confirmed individual cases. In our institute, we found pathologically diagnosed seven cases with secondary meningioma between 2000 and 2018. Totally, 364 cases were analyzed based on gender, WHO grade, radiation dose, chemotherapy. The latency years from irradiation to development of secondary meningioma were analyzed with Kaplan-Meier analysis. Spearman\'s correlation test was used to determine the relationship between age at irradiation and the latency years.
RESULTS: The mean age at secondary meningioma development was 35.6 ± 15.7 years and the mean latency periods were 22.6 ± 12.1 years. The latency periods from irradiation to the development of secondary meningioma are significantly shorter in higher WHO grade group (P = 0.0026, generalized Wilcoxon test), higher radiation dose group (P < 0.0001) and concomitant systemic chemotherapy group (P = 0.0003). Age at irradiation was negatively associated with the latency periods (r = -0.23231, P < 0.0001, Spearman\'s correlation test).
CONCLUSIONS: Cranial irradiation at older ages, at higher doses and concomitant chemotherapy was associated with a shorter latency period to develop secondary meningiomas. However, even low-dose irradiation can cause secondary meningiomas after a long latency period. Long-term follow-up is necessary to minimize the morbidity and mortality caused by secondary meningioma after cranial irradiation.
摘要：
背景：头颅照射后继发性脑膜瘤，所谓的辐射诱发脑膜瘤，是头颅放射治疗后的重要晚期效应之一。在这份报告中,我们分析了颅骨照射后继发性脑膜瘤的病例系列，并进行了文献综述，以揭示继发性脑膜瘤的特征。
方法：我们使用Pubmed，MEDLINE和Google学者数据库并调查了病理证实的个别病例。在我们的研究所，我们在2000年至2018年间发现7例经病理诊断为继发性脑膜瘤.完全正确,364例病例按性别进行分析，WHO等级,辐射剂量,化疗。用Kaplan-Meier分析分析了从照射到继发性脑膜瘤发展的潜伏期。Spearman相关性检验用于确定照射年龄与潜伏期之间的关系。
结果：继发性脑膜瘤发展的平均年龄为35.6±15.7岁，平均潜伏期为22.6±12.1岁。WHO分级较高组从照射到继发性脑膜瘤发生的潜伏期明显较短(P=0.0026,广义Wilcoxon检验),高辐射剂量组(P<0.0001)和伴随全身化疗组(P=0.0003)。照射年龄与潜伏期呈负相关(r=-0.23231,P<0.0001,Spearman相关检验)。
结论：老年人的颅内照射，在较高剂量和伴随化疗时,继发脑膜瘤的潜伏期较短.然而,即使是低剂量照射也会在长时间潜伏期后引起继发性脑膜瘤。长期随访是必要的，以最大程度地减少颅脑照射后继发性脑膜瘤引起的发病率和死亡率。
方法：我们使用Pubmed，MEDLINE和Google学者数据库并调查了病理证实的个别病例。在我们的研究所，我们在2000年至2018年间发现7例经病理诊断为继发性脑膜瘤.完全正确,364例病例按性别进行分析，WHO等级,辐射剂量,化疗。用Kaplan-Meier分析分析了从照射到继发性脑膜瘤发展的潜伏期。Spearman相关性检验用于确定照射年龄与潜伏期之间的关系。
结果：继发性脑膜瘤发展的平均年龄为35.6±15.7岁，平均潜伏期为22.6±12.1岁。WHO分级较高组从照射到继发性脑膜瘤发生的潜伏期明显较短(P=0.0026,广义Wilcoxon检验),高辐射剂量组(P<0.0001)和伴随全身化疗组(P=0.0003)。照射年龄与潜伏期呈负相关(r=-0.23231,P<0.0001,Spearman相关检验)。
结论：老年人的颅内照射，在较高剂量和伴随化疗时,继发脑膜瘤的潜伏期较短.然而,即使是低剂量照射也会在长时间潜伏期后引起继发性脑膜瘤。长期随访是必要的，以最大程度地减少颅脑照射后继发性脑膜瘤引起的发病率和死亡率。
